Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2018

Glasgow, UK
19 Nov 2018 - 21 Nov 2018

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The Society for Endocrinology BES will take place 19-21 Nov 2018 in Glasgow. Come and exchange knowledge, share experiences and strengthen collaborations across our global community of endocrinologists.

Poster Presentations

Neuroendocrinology and pituitary

ea0059p124 | Neuroendocrinology and pituitary | SFEBES2018

A single bolus of the novel kisspeptin analogue, MVT-602, induces a prolonged LH surge compared to kisspeptin-54 during the follicular phase in healthy women

Clarke Sophie A , Abbara Ali , Chia Eng Pei , Phylactou Maria , Papadopoulou Deborah , Muralidhara Koteshwara , Mills Edouard , Jones Sophie , Pratibha Machenahalli C , Chia Germaine , Yang Lisa , Izzi-Engbeaya Chioma , Sykes Mark , Prague Julia K , Comninos Alexander N , Dhillo Waljit S

Background: Kisspeptin-54 (KP54) stimulates hypothalamic GnRH release. The kisspeptin analogue, MVT-602, has a longer half-life (t1/2108min) than KP54 (t1/228mins). MVT-602 potently stimulates gonadotrophin release in men. We sought to determine for the first time the effect of MVT-602 on gonadotrophin release in healthy women.Methods: A two-phase dose-finding study was carried out in 9 healthy women, 18–35 yrs with regular men...

ea0059p125 | Neuroendocrinology and pituitary | SFEBES2018

Anti-POMC siRNA reduces ACTH secretion in an in vitro model of Cushing’s disease

Alzahrani Ahmed , Foulkes Elizabeth , Porter Julie , Kemp Elizabeth , Newell-Price John

Context: Cushing’s disease (CD) results from the release of high levels of adrenocorticotrophic hormone (ACTH) from a pituitary adenoma. Increased ACTH secretion stimulates excess cortisol production, causing weight gain, hypertension, diabetes and depression. The only curative treatment is transsphenoidal surgery, but the rate of recurrence is high and there is a lack of suitable medical therapies. RNA-interference is a mechanism of post-transcriptional gene silencing th...

ea0059p126 | Neuroendocrinology and pituitary | SFEBES2018

Natural history of conservatively managed Rathke’s cysts: a retrospective analysis of a single centre experience

Gargalas Sergios , Anguelova Lia , May Christine , Halliday Jane , Cudlip Simon , Jafar-Mohammadi Bahram , Joseph Robin , Pal Aparna

Rathke’s cleft cysts (RCC) arise from the embryonic remnants of Rathke’s pouch in the anterior pituitary gland. The majority are asymptomatic and incidentally diagnosed when the pituitary is imaged for other reasons. RCCs can progress to requiring surgical intervention for hormonal and structural effects. It is unclear what factors determine RCC enlargement and over what period this occurs, hence need for long term follow-up is uncertain. We analysed our conservative...

ea0059p127 | Neuroendocrinology and pituitary | SFEBES2018

Identifying disease causing variants in aryl hydrocarbon receptor-interacting protein (AIP) variants and their significance on the clinical phenotypes

Yang Zhou Jordi , Lillina Vignola M , Collier David , Thong Lim Chung , Iacovazzo Donato , Awad Sherine , Korbonits Marta

Introduction: Mutations in the aryl hydrocarbon receptor-interaction protein (AIP) gene predisposes to growth hormone or prolactin secretin adenomas, usually, manifesting before the age of 30 years old. There are 834 variants of the AIP reported in the GnomAD database and over 100 variants have been described in patients with pituitary adenomas. While the pathogenic role of variants resulting in truncated protein is beyond doubt, determination of the clinical...

ea0059p128 | Neuroendocrinology and pituitary | SFEBES2018

Are silent corticotroph adenomas high risk tumours for recurrence? Systematic review and meta-analysis

Fountas Athanasios , Lavrentaki Aikaterini , Subramanian Anuradhaa , Toulis Konstantinos , Nirantharakumar Krishnarajah , Karavitaki Niki

Introduction: The 2017 WHO Classification of Pituitary Tumors grades silent corticotroph adenomas (SCAs) as high-risk adenomas due to their aggressive clinical behaviour (high probability of recurrence). Nonetheless, studies comparing recurrence rates of SCA with other non-functioning pituitary adenomas (NFPAs) subtypes have provided conflicting results necessitating review of the evidence this recommendation relies on.Aims: To estimate recurrence rates ...

ea0059p129 | Neuroendocrinology and pituitary | SFEBES2018

The Utility of the high dose Short Synacthen test in pituitary patients who failed the ITT but have a low pre-test likelihood of ACTH deficiency

Muhammad Zia Ul Hussnain Hafiz , Agha Amar

The Insulin tolerance test (ITT) is regarded as the gold-standard for diagnosing ACTH deficiency but some normal subjects do not exhibit an adequate cortisol response to hypoglycaemia. Identification of false fail cases in pituitary patients is important so as to avoid unnecessary treatment with glucocorticoids. Two hundred consecutive ITTs in pituitary patients were analysed. Twenty six (13 males) failed the ITT and subsequently have a Short Synacthen test (SST). 20 patients ...

ea0059p130 | Neuroendocrinology and pituitary | SFEBES2018

Measuring of information transfer via gonadotropin-releasing hormone receptors (GnRHR) shows a remarkable loss of information through signalling

Alobaid Hussah , Voliotis Margaritis , Tsaneva-Atanasova Krasimira , McArdle Craig

Gonadotropin-releasing hormone (GnRH) is a hypothalamic neuropeptide that acts via GnRHR on the pituitary gonadotrope. It is secreted in pulses and acts via GnRHR to activate ERK and Nuclear Factor of Activated T-cells (NFAT), mediating GnRH effects on gonadotropin expression. We monitor their activation by high content imaging (fluorescence staining for ppERK and nuclear translocation of an NFAT1c-EFP reporter) in fixed LbT2 gonadotroph cells. Single cell measures reveal high...

ea0059p131 | Neuroendocrinology and pituitary | SFEBES2018

The importance of achieving disease control in Acromegaly: a retrospective single centre analysis

Varadhan Lakshminarayanan , Jose Biju , Clayton Richard

Aim: Acromegaly is associated with higher mortality and morbidity, and achieving disease control can be challenging. The aim of this study was to assess the morbidity and mortality associated with active acromegaly compared to patients in whom disease control was achieved.Methods: Retrospective analysis of all patients treated with acromegaly at a university hospital between 1948 and 2014 was performed. Mortality rates and development of new cardiovascul...

ea0059p132 | Neuroendocrinology and pituitary | SFEBES2018

Cannulated prolactin is useful to confirm hyperprolactinemia and to minimize inappropriate imaging

Almazrouei Raya , Meeran Karim

Background: Current Endocrine Society guideline recommends a single prolactin level to confirm the diagnosis of hyperprolactinemia. This may lead to over diagnosis and inappropriate imaging. Our institution protocol is to repeat the prolactin and measure macroprolactin. If the second prolactin is elevated, then a cannulated prolactin to role out venipuncture stress effect is undertaken.Methods: Data were collected for 49 patients between January 2017 to ...

ea0059p133 | Neuroendocrinology and pituitary | SFEBES2018

Characterisation of paediatric craniopharyngiomas in a single centre study – analysis of factors affecting recurrence rates

Rogers Miranda , Davies Dawn-Marie , Halliday Jane , Pal Aparna , Marland Anne , Foord Tina , Jafar-Mohammadi Bahram

Craniopharyngioma is a rare benign pituitary tumour that occurs in children and adults. Recurrence rates are high (up to 90%) but factors underpinning this are unclear, particularly in cases of childhood onset. We aimed to investigate factors that may influence subsequent recurrence rates in childhood onset craniopharyngiomas in patients attending our centre. A retrospective study of patients followed up at the Oxford Late Effects of Childhood Cancer service was conducted. Pat...

ea0059p134 | Neuroendocrinology and pituitary | SFEBES2018

Prolactin as a surrogate marker of prolactinoma diagnosis in PCOS

Dimitriadis Georgios K , Kyritsi Eleni Magdalini , Angelousi Anna , Mehta Hiten , Shad Amjad , Mytilinaiou Maria , Kaltsas Gregory , Randeva Harpal S

Background: To identify a serum prolactin (PRL) cut-off value indicative of a PRL-producing adenoma in women with polycystic ovarian syndrome (PCOS) and hyperprolactinaemia and characterize such patients. Materials and methods: In the present retrospective case–control study, the medical records of 528 PCOS women were reviewed. Pituitary magnetic resonance imaging (MRI) was performed in PCOS patients with PRL levels ≥94.0 ng/ml and/or symptoms suspicious of a pituit...

ea0059p135 | Neuroendocrinology and pituitary | SFEBES2018

Bolus 3% saline restores cognitive function more rapidly than traditional slow intravenous infusion of 3% saline in the emergency treatment of SIAD, with symptoms of cerebral irritation

Garrahy Aoife , Dineen Rosemary , Hannon Anne Marie , Zia-ul-Hussnain HM , Cuesta Martin , Sherlock Mark , Thompson Chris

Acute hyponatraemia is a medical emergency with high mortality. Recent expert guidelines advocate treatment with intravenous boluses of 3% saline with the aim to reduce cerebral oedema more rapidly than traditional slow intravenous infusion, but there is a poor evidence base for this policy change. We retrospectively audited treatment of symptomatic hyponatraemia due to SIAD (n=57, age 22–76 year), comparing low dose (20 ml/h) and bolus infusion of 3% saline. Bol...

ea0059p136 | Neuroendocrinology and pituitary | SFEBES2018

Recovery of the hypothalamic-pituitary-adrenal and thyroid axes up to 12 months following trans-sphenoidal adenomectomy

Gunatilake Sonali , Pofi Riccardo , Macgregor Victoria , Cudlip Simon , Jafar-Mohammadi Bahram , Tomlinson Jeremy , Pal Aparna

Background: Hypopituitarism is a potential complication of trans-sphenoidal adenomectomy (TSA). Recovery of pituitary function can occur, and reassessment is required to avoid unnecessary hormonal replacement. However, frequency of re-testing is variable across centres. Aim of this study was to determine recovery rates and time to recovery of hypothalamo-pituitary adrenal (HPA) and thyroid axis after TSA.Methods: We performed a single-centre, retrospecti...

ea0059p137 | Neuroendocrinology and pituitary | SFEBES2018

Safety of prescribing for inpatients with cranial diabetes insipidus (CDI): a Southwest Peninsula Audit

Edeghere Simon , Morton Claire , Rogers Sue , Babiker Tarig , Elzain Yamin , Brooke Antonia , Network Peninsula Endocrine

Cranial Diabetes Insipidus (CDI) is associated with significant polyuria and is treated with desmopressin. Inappropriate or missed treatment can result in significant electrolyte imbalance and potential harm. A recent UK survey of Endocrinologists reported 55% had concerns about knowledge in their trust, 39% felt they had observed patients come to harm. Patients not receiving desmopressin have been associated with death, leading to an NHS England (NHSE) safety alert in 2016. W...

ea0059p138 | Neuroendocrinology and pituitary | SFEBES2018

Outcomes of bilateral adrenalectomy in ACTH-dependent Cushing’s syndrome

Samani Niraj , Fountas Athanasios , Chai Shu Teng , Gleeson Helena , Ayuk John , Arlt Wiebke , Toogood Andy , Gittoes Neil , Karavitaki Niki

Introduction: Bilateral adrenalectomy (BADx) is a treatment option in ACTH-dependent Cushing’s syndrome refractory to other therapeutic modalities or can be an emergency measure in cases with severe manifestations of hypercortisolaemia.Aim: To review the outcomes of our patients with ACTH-dependent Cushing’s offered BADx.Methods: Records of patients with ACTH-dependent Cushing’s managed by BADx and seen in our Depart...

ea0059p139 | Neuroendocrinology and pituitary | SFEBES2018

Postoperative metabolic profile of patients after pituitary surgery

Rajaratnam Simon , Jeyaseelan Lakshmanan , Chacko Ari George

Objective: To study the metabolic profile of patients after surgery for pituitary tumors.Methods: This retrospective study included 1138 patients from 2000 to 2017. Those with prolactinomas, pituitary apoplexy and surgery elsewhere were excluded. The analysis included 525 patients, non-functional tumors (143), acromegaly (267), Cushing’s disease (113) and TSHoma (1). The patients’ blood pressure, blood sugar, lipid profile and body mass index (...

ea0059p140 | Neuroendocrinology and pituitary | SFEBES2018

Metoclopramide Test: Time for a revival in patients without classic symptoms and mild hyperprolactinaemia?

Bhatt Dhruti , Graveling Alex , Philip Sam , Abraham Prakash

Background: Generally Endocrinologists strive to diagnose conditions biochemically prior to radiological investigation. Pituitary incidentalomas are observed in 10% of pituitary MRIs and together with stress induced hyperprolactinaemia, 10–20% of patients receive dopamine agonists (DAs) without a definite diagnosis. Menstrual imbalance is a common symptom of hyperprolactinaemia which can have multiple origins (e.g. hypothalamic, pituitary or ovarian). DAs have side effect...

ea0059p141 | Neuroendocrinology and pituitary | SFEBES2018

Active management of severe hyponatraemia by endocrinologists is associated with lower mortality

Garrahy Aoife , Hannon Anne Marie , Cuesta Martin , Murphy Bryan , Tormey William , Sherlock Mark , Thompson Chris

Severe hyponatraemia (SHN, <120 mmol/l) is reported to be associated with mortality as high as 50%; although there are several international guidelines for management of SHN, there are few data on the impact of treatment. We have longitudinally audited our treatment outcomes of SHN. We present the results of three audit periods, of six months each, from 2005, 2010 and 2015. The three periods represented; 2005, prior to hospital policy for SHN, 2010, audit of impact of poli...

ea0059p142 | Neuroendocrinology and pituitary | SFEBES2018

A single-centre audit of treatment outcomes in 185 acromegaly patients under regular follow-up

Muhammad Shoaib Khan Sardar , Mola Laura , Perez-Fernandez Leticia , Vincent Alex , Grossman Ashley , Cudlip Simon , Jafar-Mohammadi Bahram , Pal Aparna

Transsphenoidal adenomectomy (TSA) is the recommended primary therapy in most patients with acromegaly and results in remission for majority of microadenomas and a proportion of macroadenomas depending on extent of surgically accessible disease. Acromegaly is associated with significant mortality and morbidity, hence a combination of treatment modalities may be needed to achieve disease control.Methods: A retrospective casenotes review was conducted and ...

ea0059p143 | Neuroendocrinology and pituitary | SFEBES2018

Prevalence of sinonasal mucosal disease before and after treatment of acromegaly

Chai Shu Teng , Hox Valerie , Ayuk John , Ahmed Shahzada , Karavitaki Niki

Introduction: High incidence of polyp formation and mucosal hypertrophy in paranasal sinuses have been reported in patients with acromegaly. Lund-Mackay score is widely used to stage chronic rhinosinusitis.Aim: To assess changes in Lund-Mackay score after surgical or medical treatment of acromegaly and their relation to biochemical disease activity.Methods: Records of patients with paired (before and after treatment) pituitary/sinu...

ea0059p144 | Neuroendocrinology and pituitary | SFEBES2018

25 years of sporadic insulinomas - A case series

Dales Jolyon , Bhake Ragini , Reddy Narendra , Levy Miles

Introduction: An insulinoma is a rare neuro-endocrine tumour originating in the pancreatic beta-cells with unregulated secretion of insulin resulting in profound hypoglycaemia.Methods: A search of electronic hospital records identified all patients with a primary diagnosis of insulinoma. Clinic and discharge letters, radiology investigations, laboratory investigations and case notes were reviewed to highlight the presentation, investigations and laborato...

ea0059p145 | Neuroendocrinology and pituitary | SFEBES2018

Isoforms of the short chain alcohol dehydrogenase reductase enzyme 11βHSD1L is differentially expressed in the pituitary, gonads and gastrointestinal tract

Greatorex Spencer , Cole Timothy

The human Short-chain alcohol Dehydrogenase Reductase (SDR) superfamily of oxoreductase enzymes regulate important endocrine hormones. Two SDR members, 11b-hydroxysteroid dehydrogenase (11bHSD) 1 & 2 have key roles in the pre-nuclear receptor modification of glucocorticoid steroids, thereby contributing to regulation of fluid homeostasis, blood pressure, metabolic pathways and brain function. We have recently characterised a third structurally related HSD enzyme, 11B-HSD1L...

ea0059p146 | Neuroendocrinology and pituitary | SFEBES2018

Role of Nurr1 in the regulation of Synaptogyrin 3 (SYNGR3)

Li Lingfei , Ho Philip Wing-Lok , Liu Hui Fang , Lam Colin , Pang Shirley , Ho Shu-Leong , Ramsden David

SYNGR3 is involved in the re-uptake of dopamine (DA) into striatal pre-synaptic terminals. Here we elucidate the genetic control of human SYNGR3 gene (SYNGR3).Methods and Intermediate Results: Step 1 Potential cis-acting in 2kb upstream of the transcription initiation site (TIS) of SYNGR3 were investigated using the MatInspector algorithm. Three potential Nurr1 binding sites were identified. Step 2 PCR amplification (human DNA as templa...

ea0059p148 | Neuroendocrinology and pituitary | SFEBES2018

Investigation of gonadotroph ultrastructure secretory machinery in a novel mouse model of Patched1 deletion in folliculostellate cells

Chan Joyce , Ren Yi , Christian Helen

The sonic hedgehog (shh) pathway is known to be essential for pituitary development but little is known of its role in adult pituitary. Patched1, encoded by the Patched1 (Ptch1) gene, is a receptor for shh expressed in all cell types of the anterior pituitary. Adult onset hypogonadotropic hypogonadism has been reported in a genetically engineered mouse line with deletion of Ptch1 using S100a4 promoter driven CRE recombinase expression which is restri...